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CMS-1403-FC
is not in the office when the test is being performed.
According to the commenter, this runs counter to long
standing Medicare regulation and policy regarding the
supervision of diagnostic tests, as many of these tests do
not require physician presence during the performance of
the test. The commenter argued that changing this,
requiring physicians to be present, would only inflate
healthcare costs.
A commenter recommended that TCs and PCs of non-
purchased items performed outside the office of the billing
physician or other supplier not be subject to the anti-
markup provisions, noting that many audiologists are self-
employed and perform testing services for off-site
physicians. The commenter further asserted that audiology
services do not require physician supervision, and per CMS
transmittal 84 (issued February 29, 2008 and effective
April 1, 2008), these services are to be billed by the
provider of the service and benefits reassigned to the
employer. The commenter contended that there has been no
evidence of abuse with respect to billed audiology
services, so no change is warranted.
Response: We are adopting our proposal that, for
purposes of satisfying the requirements of Alternative 2
with respect to the TC, the TC must be both conducted and
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